Factors Associated with Patient Understanding of Preeclampsia

Objective. To explore the extent to which pregnant women understand the symptoms and potential complications related to preeclampsia and to determine the factors that are associated with better understanding. Methods. This was a cross-sectional study in which 112 pregnant patients were interviewed to determine their preeclampsia knowledge. Knowledge was evaluated using a 25-item survey addressing the symptoms, consequences, and proper patient actions associated with preeclampsia. Patients were also asked in an open-ended question to define preeclampsia; all responses were rated by three obstetricians. Information about demographics, medical and obstetrical history, and health literacy was also obtained. Health literacy was assessed using the short Test of Functional Health Literacy in Adults (S-TOFHLA). Results. Patients correctly answered only 43% of the 25 questions assessing preeclampsia knowledge. Moreover, only 14% of the patients were able to provide a definition that correctly reflected the syndrome. Factors associated with a greater proportion of correct answers on the questionnaire were higher literacy, multiparity, history of preeclampsia, and receipt of information about preeclampsia from a clinician or another information source (e.g., the Internet, television, a book, or a friend). Conclusions. Pregnant patients have a generally poor understanding of preeclampsia, although improved understanding is associated with having received information about the disease. Further investigation will be needed to determine how best to educate patients and whether this education can also decrease adverse outcomes associated with this syndrome.

[1]  G. Dildy,et al.  Maternal death in the 21st century: causes, prevention, and relationship to cesarean delivery. , 2008, American journal of obstetrics and gynecology.

[2]  M. Wolf,et al.  Health literacy and functional health status among older adults. , 2005, Archives of internal medicine.

[3]  B. Ransil,et al.  Maternal Mortality in Massachusetts—Trends and Prevention , 1987, The New England journal of medicine.

[4]  Motao Zhu,et al.  Racial disparity in hypertensive disorders of pregnancy in New York State: a 10-year longitudinal population-based study. , 2007, American journal of public health.

[5]  G. Llewellyn,et al.  Women with intellectual disability at risk of adverse pregnancy and birth outcomes. , 2008, Journal of intellectual disability research : JIDR.

[6]  G. Lindmark,et al.  Eclampsia in Sweden, 1976–1980 , 1986, Acta obstetricia et gynecologica Scandinavica.

[7]  Y. MacNab,et al.  Instituting Surveillance Guidelines and Adverse Outcomes in Preeclampsia , 2007, Obstetrics and gynecology.

[8]  S. Cavkaytar,et al.  Are clinical symptoms more predictive than laboratory parameters for adverse maternal outcome in HELLP syndrome? , 2007, Acta obstetricia et gynecologica Scandinavica.

[9]  Dotun Ogunyemi,et al.  Is Eclampsia Preventable? A Case Control Review of Consecutive Cases from an Urban Underserved Region , 2004, Southern medical journal.

[10]  G. Saade,et al.  Risk factors for abruptio placentae and eclampsia: analysis of 445 consecutively managed women with severe preeclampsia and eclampsia. , 1999, American journal of obstetrics and gynecology.

[11]  C. Berg,et al.  Pregnancy‐Related Mortality From Preeclampsia and Eclampsia , 2001, Obstetrics and gynecology.

[12]  S. Alexander,et al.  Social deprivation and poor access to care as risk factors for severe pre-eclampsia. , 2003, European journal of obstetrics, gynecology, and reproductive biology.

[13]  A. Saftlas,et al.  Epidemiology of preeclampsia and eclampsia in the United States, 1979-1986. , 1990, American journal of obstetrics and gynecology.

[14]  Y. MacNab,et al.  Current CHS and NHBPEP Criteria for Severe Preeclampsia Do Not Uniformly Predict Adverse Maternal or Perinatal Outcomes , 2007, Hypertension in pregnancy.

[15]  A. Fatusi,et al.  Maternal complications and perinatal outcomes in booked and unbooked Nigerian mothers. , 2008, Singapore medical journal.

[16]  J. Shea,et al.  Performance of the English and Spanish S-TOFHLA among publicly insured Medicaid and Medicare patients. , 2005, Patient education and counseling.

[17]  D. Baker,et al.  Development of a brief test to measure functional health literacy. , 1999, Patient education and counseling.

[18]  L. Cronbach,et al.  Time-limit tests: Estimating their reliability and degree of speeding , 1951, Psychometrika.

[19]  A. Cameron,et al.  The changing pattern of eclampsia over a 60‐year period , 1997, British journal of obstetrics and gynaecology.

[20]  J Golding,et al.  Strategies to prevent eclampsia in a developing country: II. Use of a maternal pictorial card , 2004, International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics.